School Transition After Traumatic Brain Injury (STATBI): COVID-19 Impacts on Support Services for Students with TBI

ABSTRACT

Objectives: The objective of the School Transition After Traumatic Brain Injury (STATBI) project is to rigorously evaluate the impact of BrainSTEPS, a formal return-to-school (RTS) program, on academic, social, and health outcomes for students in grades K-12 who have experienced TBI of any severity, compared to students who have no formal RTS programming. In 2020, the study shifted to examine the effects of COVID-related educational changes on students who experienced a TBI prior to the pandemic. Methods: STATBI uses a mixed method, cohort-controlled research design. The IRB-approved protocol includes electronic survey administration and virtual interviews with parents and children. The data included in this presentation is crosssectional, although the full STATBI protocol is longitudinal. Measures include standardized assessments of executive function, participation, social, and cognitive abilities, in addition to semi-structured interviews with parents, students, teachers, and BrainSTEPS team members. Between 11/2020 and 1/ 2021, 250 families were invited to participate in this portion of the study. Results: Of the 46 families that completed majority of the protocol, the average student age was 14.2 years (SD = 3.3). The sample included students with mild (n = 19), moderate (n = 12), and severe (n = 13) TBI. The average age at injury was 11.8 years (SD = 4.3) and average time since injury was 2.7 years (SD = 2.1). A total of 44 families completed the COVID questionnaire with 6.8% (n = 3) reporting that their students had been diagnosed with COVID, though none required hospitalization. Students with COVID missed 5 or more days of school. 13.6% (n = 6) of families reported a household family member having a diagnosis of COVID. Most families reported that their students were attending school in either a hybrid model (40.9%, n = 18) or fully remote (45.5%, n = 20). Families reported the following areas of accommodation were needed physical accommodations (25%, n = 11), learning/thinking (36.4%, n = 16), and behavioral/social (22.7%, n = 10). Additional interview data regarding COVID, barriers and facilitators of COVID-related school changes for children with TBI, and performance across all measures in the protocol are currently being analyzed and will be available by the time of presentation. Conclusions: The STATBI project is unique in its focus on RTS for youth with TBI, and this data is particularly pertinent as it highlights the impact of COVID-related school changes on students who experienced a TBI prior to the beginning of the pandemic. Our sample included many students who reported having mild injuries but who continued to have academic needs that warranted a referral to the BrainSTEPS program. Majority of the enrolled participants were engaged in school via hybrid or remote options with a consistent minority requiring academic supports. Implications of COVID-related school changes on students with TBI based on data collected during the first - unique and challenging - year of a longitudinal study will be discussed.